Organization
OMNI HEALTH SERVICES, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA PRIBIS MD (CFO)
(419) 897-7907
Entity
Organization
Contact information
Practice address
1200 RALSTON AVE, DEFIANCE, OH 43512-1396
(419) 783-6955
Mailing address
PO BOX 74424, CLEVELAND, OH 44194-4424
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000492483
ANTHEM
OH
01
—
05267
PARAMOUNT
OH
05
—
2800188
—
OH
01
—
612948000
DEPARTMENT OF LABOR
OH
01
—
726416
BUCKEYE
OH
Enumeration date
11/16/2007
Last updated
01/18/2019
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